CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Spencer Municipal Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $474
  • Cash Discount Price: $418
  • vs. Medicare Baseline: 4.44x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Spencer Municipal Hospital is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $418. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.44x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$418

Average discount available for prompt cash payment at this facility.

Insurance Median
$474

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $418 (391%)
Insurance Median: $474 (444%)
Cash: $418 (391% of Medicare)
Ins. Median: $474 (444% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 444% of the Medicare baseline (a markup of 344%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $93 - $94 87%
UnitedHealthcare $93 - $502 87%
Humana $94 - $529 88%
Medicaid / KanCare $104 97%
Wellmark Hmo $248 232%
Wellmark Ppo $272 255%
Healthpartners (All) $446 418%
Midlands Choice - Ilcc $474 444%
Midlands Choice - Morton Bldg $474 444%
Coventry - Commercial Hmo $502 470%
Avera Health Plan $529 495%
Coventry - Commercial Ppo $529 495%
First Choice Of Midwest $529 495%
Midlands Choice (All Others) $529 495%
Sanford Health $529 495%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals